C12_Att_10-Safety_Data_Sheet.docx
DOCX document 23 KB Posted
- Attached to
- Annex LED Lighting Federal contract opportunity
- Solicitation number
- N0025325Q0012
About this file
The document is a Safety Data Sheet for a federal contract opportunity, requiring offerors to provide detailed safety performance information and a safety management narrative. The form captures five years of safety data, including OSHA Days Away from Work, Restricted Duty, or Job Transfer (DART) rates and Total Recordable Case (TCR) rates, with instructions to explain any negative safety trends above moderate risk.
The safety narrative section requires offerors to describe their Safety Management System (SMS), including management leadership, employee involvement, hazard prevention and control, worksite analysis, and safety training. Offerors must also explain their processes for selecting and overseeing subcontractors' safety compliance. This safety documentation is part of a Naval Undersea Warfare Center Division (NUWC) Keyport solicitation for LED lighting alterations and upgrades at Naval Base Kitsap Bangor, with a government estimate of $150,000-$250,000, set aside for small businesses, and a target award date of August 4, 2025.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| C26_WA20250109_20250606_Mod3.pdf | ||
| C24_N0025325Q00120001.pdf | ||
| C11_N0025325Q0012.pdf | ||
| C12_Att_11-OSHA_Calculating_Injury_and_Illness_Incident_Rate.pdf | ||
| C11b_Att_02_WD_WA20250109_03072025.pdf | ||
| C12_Att_08-Bid_Form.xlsx | XLSX spreadsheet | |
| C12_Att_01-Material_Equipment_In_Place_List.xlsx | XLSX spreadsheet | |
| C12_Att_04-Bnr_Contractors_Guide_January_2020.pdf | ||
| C12_Att_05-OPSEC_Guide_for_Defense_Contractors.pdf | ||
| C12_Att_06-Schedule_of_Values.xlsx | XLSX spreadsheet | |
| C12_Att_03-Safety_Requirements_for_Contractors_and_Subcontractors.pdf | ||
| C11d_Att_07-Past_Performance_References.docx | DOCX document | |
| C12_Att_09-PPI_Form.docx | DOCX document |
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Text version
SAFETY DATA SHEET
This form is to be completed by the offeror. Use this form to provide safety information for the Safety factor. DART and TRC rates shall not be submitted for subcontractors.
Joint Venture (JV) or Partnership: Provide a Safety Data Sheet for each contractor who is part of the JV or partnership; however, only one safety narrative is required.
1. Offeror Name:
Name of JV partner providing the information below (if applicable):
2. Insurance Carrier Information:
Insurance Carrier Name:
Agent’s name:
Phone No.:
Email:
Offeror’s Five Previous Complete Calendar Years of Reported Safety Data:
Only complete year safety data will be considered. Indicate data rates as decimal figures, not whole numbers.
3. OSHA Days Away from Work, Restricted Duty, or Job Transfer (DART) Rate
| 2020 |
| 2021 |
| 2022 |
| 2023 |
| 2024 |
3a. If you do not have a DART Rate for a given year, affirmatively state so here and explain why:
3b. Explain any negative trend above moderate risk (DART Rates of 3.0 or greater), an acceptable/detailed explanation is required that includes any corrective actions taken for improvement:
4. Total Recordable Case (TCR) Rate
| 2020 |
| 2021 |
| 2022 |
| 2023 |
| 2024 |
4a. If you do not have a TCR Rate for a given year, affirmatively state so here and explain why:
4b. Explain any negative trend above moderate risk (TCR Rates of 4.5 or greater), an acceptable/detailed explanation is required that includes any corrective actions taken for improvement:
SAFETY DATA SHEET (Continuation)
5. Technical Approach for Safety: Provide the Safety Narrative using this form. Do not exceed 2 pages. Any additional pages will not be considered.
a. Describe the Offeror’ s approach to implementing and executing a Safety Management System (SMS) including Management/Leadership involvement, Employee involvement, Hazard prevention, Hazard control, Worksite analysis, and Safety and health training, to include the standard(s) used to benchmark the SMS.
b. Describe the evaluation process used to select potential subcontractors.
c. Describe the processes of how the Offeror will oversee safety compliance of subcontractors at all levels throughout performance of the contract (to include the Offeror’s own in-house workforce).
File details come from the government source that posted it. Updated .